Questionnaire survey(n=147)and group interview(n=13)were used for this investigation.Our results showed that 66.7%of participants considered"heavy work burden and insufficient specialists"to be the main challenge.Half of comingnity healthcare providers were not satisfied with thepayment systerm.We suggest that the overall-consideration of community healthcare service development in urban and suburb areas and 4 kinds of performance pattems should be strengthened:the perfommnce appraisal and quality control schemes should be modified;and the employee headcount in community healthcare centers or transferred employees'salary should be moderately increased in the fumre.

Benzoates ; urine ; Gas Chromatography-Mass Spectrometry ; methods ; Humans

Objective To analyze the epidemiologic feature of overseas imported malaria in order to provide the evidence for improving the surveillance and control of malaria in Wuhan City. Methods The epidemiological investigation data of overseas imported malaria cases were collected and analyzed with an epidemiological method including plasmodium species epidemic fo?cus distribution domestic distribution population characteristics attack?diagnosis interval clinical grading etc. in Wuhan City from 2008 to 2013. Results A total of 240 overseas imported malaria cases were reported including 180 cases from Afri?can countries and the proportion of Plasmodium falciparum infections was 82.22% and 60 cases from Southeast Asian coun?tries and the proportion of Plasmodium vivax infections was 76.67% and the proportions of the parasite species were significant?ly different between the two regions χ2=105.53 P 0.001 . The male and young adults were dominant. there were no statisti?cal significance between clinical grading and attack?diagnosis interval Z=-0.99 P = 0.32 vocational background χ2=10.61 P=0.10 then clinical symptoms aggravated the situation was occurred more easily among the first attack cases χ2=7.66 P 0.05 and the falciparum malaria cases χ2=24.27 P 0.001 . Conclusions The overseas imported malaria cases are increasing rapidly with years and the malignant malaria cases were more than other malaria cases in Wuhan City. Therefore the surveillance and management of the returnees from malaria endemic areas should be strengthened continually.

AIM: To compare the measurement of anterior chamber depth(ACD) inclusive of corneal thickness using intrao-cular lens(IOL) master and ultrasound biomicroscopy (UBM) and evaluate the repeatability of each method.METHODS: Two consecutive measurements of ACD were prospectively performed using IOL master and UBM in 60 eyes in 60 individuals. Mean values were compared using the paired t test. For each individual, ACD measure-ments was performed 5 times to estimate the repeatability of each method by a coefficient of variation(CV).RESULTS: The mean ACD was 2.95±0.25mm with the IOL master and 2.96±0.22mm with the UBM. This diffe-rence was not statistically significant (P=0.631).The coefficient of variation (CV) was 0.56%±0.26% and 0.65%± 0.36% in IOL master and UBM, respectively.CONCLUSION: The mean ACD of IOL master was the same as UBM. The repeatability of IOL master is better than UBM.

Fetal atrioventricular block (AVB) is a type of fetal bradyarrhythmias. The reported incidence of fetal complete atrioventricular block (CAVB) and mortality of perinatal fetuses and neonates are signiifcantly higher in pregnancies of anti-SSA/Ro-positive mothers than that of anti-SSA/Ro-negative mothers. The auto-antibodies in maternal serum that can be transported into fetal circulation through placenta may damage fetal cardiac conductive system and eventually result in fetal AVB. There are evidences that early diagnosis and proper treatment can improve the prognosis and survival rate of affected fetuses. In this article, the pathogenesis, risk factors, prenatal diagnosis, treatment and prognosis of fetal immune mediated AVB is reviewed.

Objective To study the antibacterial effect of borneol, honey, gentamicin in Ruchuang Bingmi hydropathic compress agent.Method Staphylococcus aureus(S.aureus), Escherichia coli(E.coli), Pseudomonas aeruginosa(P.aeruginosa) were used to produce the third phase of infection decubitus animal models, respectively.Vaseline as the control group, divided into 12 groups:Vaseline-S.aureus, Vaseline-E.coli, Vaseline-P.aeruginosa;Honey-S.aureus,Honey-E.coli,Honey-P.aeruginosa;Borneol -S.aureus;Borneol -E.coli;Borneol-P.aeruginosa;Gentamicin-S.aureus;Gentamicin-E.coli;Gentamicin-P.aeruginosa;6 rabbits in each group.Honey, borneol, gentamicin was made into a gauze in treatment for decubitus .Organizations do strain identification and colony counts was observed before and after taking the treatment.ResuIts Borneol group ( F =11.059,P<0.01).,there was differences of each groups count cultured by borneol;Time ×Strains(F=11.281,P=0.009),there was no significant interaction between the two groups;gentamicin(F=7.99,P=0.000),gentamicin culture showed a difference in each group count;Time ×Strains(F=12.531, P<0.07),interaction between the two groups showed significant.Borneol has no antibacterial effects on P.aeruginosa , had a certain antibacterial activityon S.aureus and E coli;gentamicin had good antibacterial effect on the three kinds of bacteria, and against P.aeruginosa was particularly significant.ConcIusion The antibacterial activity of gentamicin is better than single herbs borneol in Ruchuang Bingmi hydropathic compress agent, honey has no antibacterial effect.

Amifostine ; pharmacology ; Anemia, Aplastic ; chemically induced ; pathology ; prevention & control ; Animals ; Benzene ; toxicity ; Dose-Response Relationship, Drug ; Male ; Mice

To evaluate the effect of dexmedetomidine on prognosis after cardiac surgery with cardiopulmonary bypass (CPB) in the patients.For this retrospective study,753 patients of both sexes,aged 18-84 yr,who underwent cardiac surgery with CPB from September 2013 to May 2015,were divided into 2 groups depending on whether or not dexmedetomidine was used during surgical procedures:control group (group C,n=548) and dexmedetomidine group (group D,n =205).Propensity score matching analysis with preset caliper width was used.A total of 197 matched pairs were selected from the patients.The development of postoperative arrhythmia,in-hospital mortality,pulmonary infection after operation,and acute renal injury,length of intensive care unit stay,length of hospital stay and 30-day readmission to the hospital were collected.Compared with group C,the incidence of postoperative tachyarrhythmia and inhospital mortality rate were significantly decreased (P＜0.05),and no significant changes were found in the incidence of postoperative bradyarrhythmia,pulmonary infection after operation and postoperative acute renal injury,length of intensive care unit stay,length of hospital stay and rate of 30-day readmission to the hospital in group D (P＞0.05).Dexmedetomidine can effectively improve prognosis after cardiac surgery with CPB in the patients.

Heart Defects, Congenital ; genetics ; Humans

Objective To investigate the risk factors of acute kidney injury (AKI) in patients undergoing cardiac valve surgery with cardiopulmonary bypass (CPB).Methods A retrospective cohort database study was conducted, involving 1 349 patients undergoing heart valve surgery with CPB technique.Logistic regression was used to screen out the risk factors of AKI after the surgery.Results Of the 1 349 patients, the incidence of AKI in valve surgery was 28.4%.One year older (OR=1.05, 95%CI 1.03-1.06, P<0.001), diabetes (OR=2.11, 95%CI 1.22-3.68, P=0.008), anemia (OR=1.50, 95%CI 1.05-2.21, P=0.026), each additional basic serum creatinine of 1 mg/dl (OR=1.01, 95%CI 1.01-1.02, P=0.001), each additional operation time of 1 hour (OR=1.28, 95%CI 1.15-1.41, P<0.001), plasma transfusion during surgery (OR=1.50, 95%CI 1.14-1.97, P=0.004) were the independent risk factors for AKI in multivariate logistic regression model.Conclusion AKI is a common and serious complication following cardiac valve surgery.More attention should be paid to the patients with elder age, anemia, prolonged operation time, diabetes, increased basic serum creatinine and requirement of plasma transfusion during surgery.